Active NPI
Mary D Bradley, PHARM.D
- Pharmacist
- Inglewood, CA
National Provider Identifier
1477846434
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 57492
- Practice address
- 3471 W Century Blvd
Inglewood, CA 90303-1218 - Phone
- (310) 677-5937
- Fax
- (310) 677-5937
- NPI assigned
- May 24, 2011
- Last updated
- May 24, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 57492 | CA | Primary |
Addresses
Primary practice location
3471 W Century Blvd
Inglewood, CA 90303-1218
Mailing address
3471 W Century Blvd
Inglewood, CA 90303-1218
Phone (310) 677-5937
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 410215170 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 57492 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306195200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1306195200000",
"number": "1477846434",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3471 W CENTURY BLVD",
"city": "INGLEWOOD",
"state": "CA",
"postal_code": "903031218",
"telephone_number": "310-677-5937",
"fax_number": "310-677-5937"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3471 W CENTURY BLVD",
"city": "INGLEWOOD",
"state": "CA",
"postal_code": "903031218",
"telephone_number": "310-677-5937",
"fax_number": "310-677-5937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRADLEY",
"first_name": "MARY",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "PHARM.D",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-24",
"last_updated": "2011-05-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CA",
"license": "57492",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "410215170",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Inglewood, CA
- Vanessa Leshana Boykin, LVN
- Braden Partners LP (Pacific Pulmonary Services)
- Adrienne Marie Braden, MSW
- Renee Gaynell Bradley Porter, LVN RAC-C
- Kevin Jamal Bradley
- Verda R Bradley, PHD, LCSW, M.ED,
- Nalini Brahmbhatt, M.D.
- Ronda Lei Angelia Branch
- Dana Arceneaux Brathwaite, P.T.
- John Bernard Braunstein, M.D.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.